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| ID | Type | Description | Link |
|---|---|---|---|
| CDMRP-SC220220 | Other Identifier | Department of Defense |
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We are closing this clinical protocol due to supply chain issues. We are no longer able to obtain the intranasal delivery device.
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| Name | Class |
|---|---|
| Uniformed Services University of the Health Sciences | FED |
| Congressionally Directed Medical Research Programs | FED |
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The purpose of this study is to find out whether insulin, a drug approved by the FDA for the treatment of diabetes mellitus, reaches the brain and spinal cord when delivered as a nasal spray (intranasally). Intranasal insulin has been shown to improve memory and mood in patients with neurological diseases such as mild cognitive impairment and dementia, but more evidence is needed to support the ability to effectively target the brain through intranasal routes.
18 healthy middle-aged adults will be randomly assigned to receive a single intranasal dose of 40 units insulin ("low dose" group), 80 units insulin ("high dose" group), or saline (placebo, or control group). Participants will undergo an image-guided lumbar puncture (spinal tap) performed by a study clinician. Samples of cerebrospinal fluid (a fluid surrounding the brain and spinal cord) and blood will be collected at 5 timepoints during the lumbar puncture: once prior to the administration of intranasal insulin, and again at 10, 20, 30, and 40 minutes after the dose is given. Samples will be tested to determine the level of insulin detected in the cerebrospinal fluid and blood at each time point. Results of this study will provide essential information about the ability of insulin to reach the brain after intranasal administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low dose intranasal insulin | Experimental | One dose of 40 international units of regular insulin administered intranasally. |
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| High dose Intranasal Insulin | Experimental | One dose of 80 international units of regular insulin administered intranasally. |
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| Placebo Control | Placebo Comparator | One dose of 0.9% saline administered intranasally. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low Dose Regular insulin | Drug | Administered intranasally at 40 IU |
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| Measure | Description | Time Frame |
|---|---|---|
| Concentration of insulin over Time - Cerebrospinal fluid | Insulin concentration detected in cerebrospinal fluid at 5 time points (pre-insulin dose; and 10, 20, 30, 40 minutes after dose). Values will be reported as μIU/mL. Higher values indicate a greater concentration of insulin in the cerebrospinal fluid. Concentrations for each time point (overall and by dose) will be reported as a mean +/- standard error. | 0-40 minutes post-intranasal administration |
| Cmax of insulin concentration- Cerebrospinal Fluid | CSF insulin concentration will also be reported by Cmax (peak concentration) | 0-40 minutes post- intranasal administration |
| Tmax of insulin concentration-Cerebrospinal FLuid | CSF insulin concentration will also be reported by Tmax (time of peak concentration) | 0-40 minutes post-intranasal administration |
| AUC (area under the curve) of insulin concentration-Cerebrospinal Fluid | CSF insulin concentration will also be reported by AUC (area under the curve, measured as time x concentration) | 0-40 minutes post-intranasal administration |
| Measure | Description | Time Frame |
|---|---|---|
| Insulin Concentration Over Time- Serum | Insulin concentration detected in blood at 5 time points (pre-insulin dose; and 10, 20, 30, 40 minutes after dose). Values will be reported at μIU/mL. Higher values indicate a greater concentration of insulin in the blood. Concentrations for each time point (overall and by dose) will be reported as a mean +/- standard error. | 0-40 minutes post-intranasal administration |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Leah R Hanson, PhD | HealthPartners Institute | Principal Investigator |
| Kimberly Byrnes, PhD | Uniformed Services University of the Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| HealthPartners Neuroscience Center | Saint Paul | Minnesota | 55130 | United States |
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| ID | Term |
|---|---|
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D007328 | Insulin |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D011384 | Proinsulin |
| D061385 | Insulins |
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
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Participants will be randomized into one of 3 groups: 40 IU insulin, 80 IU insulin, or saline control.
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Single-blind
| High Dose Regular insulin | Drug | Administered Intranasally at 80 IU |
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| 0.9% Saline | Other | Placebo control |
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| Cmax of insulin concentration - Serum | Serum insulin concentration will also be reported by Cmax (peak concentration) | 0-40 minutes post-intranasal adminitration |
| Tmax of insulin - Serum | Serum insulin concentration will also be reported by Tmax (time to peak concentration) | 0-40 minutes post-intranasal administration |
| AUC (area under the curve) of insulin concentration - Serum | Serum insulin concentration will also be reported by AUC (area under the curve, measured as time x concentration). | 0-40 minutes post-intranasal administration |
| D006728 |
| Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |